What You Need to Know About Fasting If You Have Psoriatic Arthritis

If you have psoriatic arthritis (PsA), the food that’s recommended for you is the same that's good for people with heart disease, cancer, and diabetes. Many of these foods, like fruits, vegetables, nuts, and some fish, have anti-inflammatory properties that can help you manage your condition.

Foods that trigger psoriatic arthritis include saturated fats, sugar, alcohol, and simple carbohydrates. They can contribute to weight gain and potentially increase pressure on your joints. Keeping your weight at a healthy level is key to managing psoriatic arthritis.

Types of Intermittent Fasting

Intermittent fasting is an eating plan that switches between fasting and eating on a regular schedule. The idea is that while you are fasting, your body uses up its sugar supply and burns stored fat. This process is known as metabolic switching.

Fasting times vary, but you can select a schedule that works best for you. Fasting times include:

• Fasting for 16 hours and eating one or two meals during the eight-hour period
• Eating five days, but for two days, only eating one meal that’s limited to 500–600 calories

Longer periods without food, such as 24-, 36-, 48-, and 72-hour fasting periods, are not necessarily better for you and may be dangerous. Going too long without eating might actually encourage your body to start storing more fat in response to starvation.

Benefits for Psoriatic Arthritis

If you have psoriatic arthritis, you will benefit in losing weight if you are overweight. By managing your weight, you can reduce the risk of other medical conditions linked to PsA and can reduce the pressure placed on your joints. 

Apart from losing weight, studies in both animals and humans show that intermittent fasting speeds up metabolism and influences the circadian rhythm, gut microbiota, and lifestyle habits. Research shows that intermittent fasting can optimize autophagy, the process through which the cells in our body are recycled and regenerate, and it may slow cellular aging.

Research also has shown that intermittent fasting has a positive impact on the activity of psoriatic arthritis as measured by the Psoriasis Area Severity Index (PASI). Intermittent fasting is also associated with an improvement in the disease activity scores, enthesitis (inflammation of the entheses) and dactylitis (painful swelling of the fingers and toes). 

Studies have further indicated that patients with rheumatoid arthritis (RA), another inflammatory form of arthritis, who engaged in fasting had a rapid immune response with reduced inflammation. However, when the fasting ended and food was reintroduced, inflammation returned and symptoms reappeared.

Risks

The safety and long-term effects of intermittent fasting are still unclear. You should discuss your plans with your doctor and a nutritionist to determine if intermittent fasting is suitable for your lifestyle. Intermittent fasting comes with the following risks:

• Feeling sick: You could have headaches, lack of energy, moodiness, and constipation from fasting. If you experience these side effects, consider cutting the amount of time you fast or fast only periodically rather than continuously.
• Overeating: Once the fasting period ends, people may overeat and binge on unhealthy food on days they don’t fast. A 2018 study discovered that when you’re on a calorie-restricted diet, your metabolism slows down and you have a bigger appetite. In addition, research has shown that your circadian rhythm gets thrown off with time-restricting eating, which may lead to metabolic problems.
• Older adults losing too much weight: There isn’t enough evidence of the benefits of intermittent fasting for older adults. Current studies have only examined small groups of younger and middle-aged adults for just a short time period. Losing too much weight can affect bones, the immune system, and energy levels.
• Potential danger with certain medications: Many people with PsA also have other medical conditions like heart disease and diabetes. Intermittent fasting can be dangerous if you have diabetes and if you are taking medication for high blood pressure or heart disease. Imbalances of certain minerals like sodium, potassium, and other minerals can occur when you fast. Also, some medications require you to eat when you take them, or you risk nausea and stomach irritation. 

Who Should Not Fast

Avoid fasting if you're taking medications for diabetes, high blood pressure, and heart disease. Also, you should not fast if you’re pregnant or breastfeeding. Children and the elderly should also avoid fasting. 

Psoriatic Arthritis Doctor Discussion Guide

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Summary

Intermittent fasting involves eating and fasting on a regular schedule. Research has shown that intermittent fasting holds many benefits, including speeding up your metabolism, optimizing cell turnover, and helping you lose weight. It could potentially help with psoriatic arthritis by reducing disease severity and alleviating symptoms like enthesitis and dactylitis.

However, it is also linked to certain risks, including overeating after fasting, losing too much weight, and causing problems with medications you take for other conditions.

A Word From Verywell

Psoriatic arthritis can be managed. Before you decide to make dramatic changes to your diet, like starting intermittent fasting, talk to your doctor and discuss the pros and cons first. When in doubt, speak to a nutritionist who specializes in psoriatic arthritis. A nutritionist can provide you with guidance on which foods may cause uncomfortable and painful flare-ups and which foods can help with your condition.

Frequently Asked Questions

What foods trigger psoriatic arthritis?

Avoid processed meats that are high in saturated fat and sodium, alcohol, sugary drinks like soda, packaged snack foods, white bread, rice, candy, and fried foods. These foods can trigger inflammation and worsen symptoms of psoriatic arthritis.

What causes psoriatic arthritis flare-ups?

Apart from an unhealthy diet high in fat, sodium, sugar and processed foods, skipping and stopping any prescribed medication for the condition can also lead to a flare-up, a time when symptoms increase. A sunburn can cause a skin flare-up. Injury-induced flare-ups, called the Koebner phenomenon, can affect your joints. The key to minimizing flare-ups is to manage stress, get adequate sleep, maintain a healthy weight, and exercise regularly.